RESUMEN
BACKGROUND: Urinary incontinence (UI) is an important geriatric syndrome that has been associated with a wide range of health-related outcomes. However, UI severity has rarely been examined in the context of a comprehensive geriatric assessment. Therefore, the aim of this study is to examine the association between UI severity and health-related quality of life (QoL) when frequent geriatric issues are taken into account. METHODS: We performed a cross-sectional study of 1,124 participants aged 70 y and older. UI was diagnosed when difficulty with urinary continence was reported, and its severity was assessed through a modified version of the Sandvik Index. Health-related QoL was measured using the SF-36, including its physical and mental component summaries. Multivariate linear regression was performed to determine the association between UI severity and health-related QoL. RESULTS: Prevalence of UI was 18%, and it was severe in 29.3% of cases. Severely incontinent subjects were older and had worse self-perceived health status, greater disability, and more depressive symptoms in comparison with continent participants or with those affected to a lesser degree. Multivariate regression analysis showed a significant inverse association between the physical component summaries and moderate (B = -4.54) as well as severe UI (B = -6.72). The mental component summaries showed similar results (B = -1.44 and -4.43, respectively). CONCLUSIONS: UI severity is associated with lower QoL scores in both its components. This association appears to be more important as severity increases. UI severity must be evaluated thoroughly in the elderly because of its potential adverse effects on physical and mental health.
Asunto(s)
Evaluación Geriátrica/métodos , Calidad de Vida , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/epidemiología , Distribución por Edad , Anciano , Análisis de Varianza , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Anciano Frágil , Humanos , Vida Independiente , Modelos Lineales , Masculino , México , Análisis Multivariante , Prevalencia , Características de la Residencia , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Factores Socioeconómicos , Incontinencia Urinaria/psicología , Adulto JovenRESUMEN
Abnormalities in liver function tests could be produced exclusively by direct inflammation in hepatocytes, caused by the human immunodeficiency virus (HIV). Mechanisms by which HIV causes hepatic damage are still unknown. Our aim was to determine the correlation between HIV viral load, and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as markers of hepatic damage in HIV naive infected patients. We performed a concordance cross-sectional study. Patients with antiviral treatment experience, hepatotoxic drugs use or co-infection were excluded. We used a Pearson's correlation coefficient to calculate the correlation between aminotransferases serum levels with HIV viral load. We enrolled 59 patients, 50 men and 9 women seen from 2006 to 2008. The mean (+/- SD) age of our subjects was 34.24 +/- 9.5, AST 37.73 +/- 29.94 IU/mL, ALT 43.34 +/- 42.41 IU/mL, HIV viral load 199,243 +/- 292,905 copies/mL, and CD4+ cells count 361 +/- 289 cells/mm(3). There was a moderately strong, positive correlation between AST serum levels and HIV viral load (r = 0.439, P < 0.001); and a weak correlation between ALT serum levels and HIV viral load (r = 0.276, P = 0.034); after adjusting the confounders in lineal regression model the correlation remained significant. Our results suggest that there is an association between HIV viral load and aminotransferases as markers of hepatic damage; we should improved recognition, diagnosis and potential therapy of hepatic damage in HIV infected patients.